What to Know About Dermoid Cysts Around the Eyes

Medically Reviewed by Dany Paul Baby, MD on August 24, 2022
5 min read

A dermoid cyst around the eyes usually forms when the baby is in the uterus. This article explains the ways dermoid cysts are formed, their causes, symptoms, and possible treatment options.

A dermoid cyst is an abnormal growth of non-cancerous tissue under the skin. These cysts may contain hair follicles, skin tissue, sweat, and oil. Sometimes cysts also contain teeth and bones. Although these cysts may form in different parts of your body like your head, neck, or face, they’re most commonly found in the eyes.

The cysts are typically present at birth but may grow over time. Dermoid cysts have two types.

Orbital dermoids. These are usually found at the end of the eyebrows, near the nose, where the bones of the eye socket are located. Orbital dermoids form below the skin’s surface and are not directly visible. These cysts are smooth, contain a greasy yellow substance, and are usually not painful. They are not known to cause any loss in vision, but removal of dermoid cysts from the eyes is vital, as they grow larger over time.

Sometimes, orbital dermoids may be dumbbell-shaped. In such incidences, one section forms outside the eye socket while the other forms on the inside. Orbital dermoids may burst and cause inflammation, so doctors recommend removing them right away. According to research, dermoid cysts are one of the most commonly occurring orbital tumors in children, making up roughly 45% of all childhood neoplasms (abnormal tissue mass).

Epibulbar dermoids. These cysts are further grouped into two types, posterior epibulbar dermoids and limbal dermoids. The first type is a cyst that usually contains some hair and takes the shape of the eye. These cysts are commonly found on the outer part of the upper eyelid. You’ll be able to see these cysts only during certain eye movements.

Limbal dermoid cysts grow on the eye, either in the cornea or the point where the cornea and sclera join. Limbal dermoids may hamper a child’s vision as they grow larger and can also modify the shape of the cornea. This leads to an eye condition called astigmatism, which blurs your vision. If astigmatism is not treated in time, your brain gets used to this blurry vision causing a condition known as lazy eye (amblyopia).

Dermoid cysts are a congenital condition and are present at the time of birth. They are typically formed due to a disruption affecting how the skin layers grow together. 

Cysts are formed during the early phases of the child’s growth in the uterus. Skin cells, tissues, and glands are parts of the skin that come together to form a lump. These glands keep producing fluids that cause the lump to grow even larger and form cysts. So, one of the easiest ways to understand dermoid cysts is to think of them as skin stuck under the surface.

A dermoid cyst is commonly found as a lump that is visible in the affected area. In most cases, the cyst is painless, but sometimes, it may put pressure on the eyeball that could cause pain and affect your child’s vision. These cysts are nothing but a collection of skin cells and tissues. They continue to carry out the same actions as other skin, though, releasing oil and discarding old cells. When the enlarged dermoid cyst grows into the bone (usually the skull), the gap in the affected bone also becomes wider as the cyst grows.

Doctors generally carry out a physical examination to pinpoint the location and appearance of the cyst and inspect other parts of your child’s eyes. A physical inspection usually reveals an orbital dermoid cyst. Ophthalmologists (eye doctors) typically look for some of the following signs:

  • A rubbery growth over the eyebrow or near the nose
  • A droopy eyelid
  • Inflammation in the eye

Your doctor may also run specific tests to identify whether your child has deeper dermoid cysts and locate them. Some of these tests include:

X-ray. This gives the doctor a clear view of the areas where the cysts are formed.

Computerized Tomography (CT) scan. A CT scan and an x-ray create detailed images of the affected area.

Magnetic Resonance Imaging (MRI). An MRI scan uses a combination of large magnets, radio waves, and computer imaging to provide clear images of the affected parts.

CT and MRI scans are non-invasive tests and give your doctor accurate images of the cyst. This tells them if the cyst is near a sensitive area such as a nerve and helps them decide on the most suitable treatment method.

Some dermoid cysts may affect your child’s vision while others could burst and cause further complications. In such cases, your doctor may recommend surgery to remove the errant tissue. 

Posterior epibulbar dermoids are typically linked to the conjunctiva (the outer lining of your eyeball right under the eyelids) of your child’s eye. Sometimes, it may extend right up to the eye socket and cannot be removed completely. Your doctor will decide if surgery would be beneficial. If so, they may only partially remove the cyst.

Limbal dermoids may need to be removed completely, as they affect the cornea. Removing dermoid cysts from the eyes restores vision in most cases. It also reduces any discomfort and irritation that was present before surgery. However, in many cases, limbal dermoids permanently change the shape of the cornea, and there could be a recurrence of amblyopia in such instances. 

Schedule regular follow-up appointments with your doctor after surgery to make sure your child gets proper care. In many cases, vision can be restored if a condition is detected early.

Dermoid cysts around the eyes are benign but should be attended to right away to avoid further complications.

  • Dermoid cysts are non-cancerous tissues that form during the early stages of your child’s growth in the uterus.
  • Two types of dermoid cysts affect the eyes – orbital and epibulbar. These cysts may affect your child’s vision as they become larger over time. In some cases, they may rupture and cause inflammation.
  • While removing dermoid cysts surgically is recommended in many cases, check with your doctor to find the best treatment options for your child.
  • Keep in mind that some cysts may recur even after successful surgery. In such cases, follow-up care from your doctor is critical.